Many medical diagnostic tests are performed in a medical laboratory, on serum and plasma. Serum is the yellow liquid obtained from “whole blood” (also referred to as blood) after the blood is allowed to clot, and the clot is removed by centrifugation; plasma is the yellow liquid obtained from blood by centrifugation of blood before the blood is allowed to clot, and the packed red cells are removed by centrifugation. Plasma is usually obtained by adding an anticoagulant like heparin to the blood, to prevent clotting.
Spectroscopy or spectroscopic methods, with and without reagents added to the sample, are common methods used to measure analytes in serum and plasma. In spectroscopic measurements, the hemoglobin inside the red cells absorbs a very significant portion of the incident or illuminating electromagnetic radiation (EMR), and the red cells cause significant attenuation of the incident EMR due to scattering of EMR away from the photodetector. Therefore, when one is interested in the plasma concentration of an analyte, the serum or plasma is preferred. As an example, bilirubin measurement by spectroscopy is accomplished much easier in serum and plasma than in whole blood. On the other hand, certain analytes can only be measured in blood because they only exist within the red cells, for example the various hemoglobin species.
Currently, not all diagnostic tests can be performed by spectroscopic methods, and the use of biosensors is another example of measurement techniques that can assist in expanding the menu of diagnostic tests. Because serum and plasma are less viscous that blood, serum or plasma may be preferred to blood when certain biosensors are employed.
Another reason for preferring serum and plasma over whole blood, is the ability to detect hemolysis, turbidity, and elevated bilirubin in the serum and plasma, which cannot be detected in whole blood, and which affect the accuracy of many analyte measurements. Hemolysis is the release of hemoglobin and other red cell contents into the plasma or serum after rupture of red blood cells, and turbidity is the presence of light-scattering particles, for example, fat particles in the blood.
In point-of-care testing or near patient testing, the preferred sample is whole blood because the time and cost required for clotting and/or centrifugation is eliminated, and less blood is required. A drop of blood from a pin prick is the sample of choice for point-of-care testing or measuring devices. However, if plasma or serum were as readily available as a drop of blood, they would be preferred over whole blood for measurement of most analytes.